Weekly News From Los Alamos County
December 9, 2022
Inside this newsletter, you will find...
The Epidemiology Corner - COVID-19 Update, Data Shows Bivalent Booster Effective, Boosters Authorized for Kids <5, Tripledemic Strains Hospitals, and Big Cities Move Back to Masks, Weekly Survey, COVID-19 data, and more.
COVID-19 Update:
Elevated Burden of COVID-19, Influenza, and RSV Illness Continues Going Into the Holidays...
COVID-19 Update: Omicron BQ.1x Variants Dominate as XBB and BN.1 Variants Slowly Emerge 

Omicron variants BQ.1 and BQ.1.1 (BQ.1x) continue ascending in predominance and now account for 68% of cases nationwide, according to CDC forecasts. Two other variants, XBB and BN.1, are slowly ascending in prevalence, but each still accounts for less than 5% of cases nationwide. All other variants circulating in the US appear to be stable or descending in prevalence, particularly the formerly predominant variant BA.5, which now accounts for roughly 10% of cases. See HERE  All variants currently circulating are Omicron descendants, and although vaccines and oral antivirals still provide protection, CDC is encouraging people to wear masks to help prevent spread of COVID-19, flu, and RSV over the holidays. See HERE


COVID-19 in the County: Community Level Risk Remains at LOW  
 
For the week ending December 7, the Community Level was LOW for Los Alamos County, as it was for the three other counties (Taos, Rio Arriba, Santa Fe) which collectively comprise the regional Health Services Area (HSA) over which CDC hospitalization metrics are calculated. County incidence rates continue to mirror the case incidence reported in the three neighboring HSA counties. The HSA hospitalization rate declined modestly from 9.9 to 7.9 new admissions per 100,000. NMDOH reported no new COVID-19 hospital admissions for Los Alamos County residents for the week ending December 5. See HERE


Weekly Emergency Department Visits for COVID-Like Illness Remain Elevated

NMDOH reports the percentage of emergency department (ED) visits in county residents for COVID-like illness remained elevated at 12.2% for the two-week period ending December 6.  In comparison, the percentage of ED visits statewide for COVID-like illness statewide currently ranges from 6% to 8%.  At present, the percentage of statewide ED visits for influenza-like illness (16%) is about twice as high as that for COVID-like illness. See HERE   


Wastewater Surveillance Data Indicate BQ.1x Variants Likely Approaching Dominance in the County

SARS-Cov-2 virus levels in county wastewater remain at levels consistent with the stable level of cases being reported over the past several weeks. For the week of November 21, genomic sequencing of detected virus revealed a nearly 40% prevalence of the BQ.1x variants, with the remainder involving BA.5 variant. See https://biobot.io/data/  The current nationwide predominance of BQ.1x variants (68%) makes it likely that the BQ.1 and BQ1.1 variants also now predominate in the county and account for the majority of infections. 


New Mexicans Encouraged to use NM Notify app to Report Positive COVID-19 Home Tests

To assist with more complete case monitoring in New Mexico, NMDOH encourages residents to download the NM Notify app and to report positive COVID-19 home tests on the app. See the NMDOH press release HERE. NMDOH has retired the online self-reporting tool for COVID-19 rapid home tests formerly available on its website. The NMDOH/CDC COVID-19 incidence data reviewed here are based on PCR-confirmed testing results and do not include data on positive at-home antigen tests.  As such, case counts are incomplete and underestimated, but by how much cannot be determined precisely at any given time point. 

News
First Real-World Data Show That the Bivalent Booster Is Effective

In a report published in the Morbidity and Mortality Weekly Report, scientists at the U.S. Centers for Disease Control and Prevention (CDC) provided the first real-world evidence on the effectiveness of the bivalent booster shot that the CDC and the U.S. Food and Drug Administration (FDA) authorized in September.

The researchers conclude that the bivalent booster, which contains genetic material from both the original SARS-CoV-2 virus and the Omicron BA.4/5 variants, is effective in protecting people from severe COVID-19. The relative effectiveness among people ages 18 to 49 who received the bivalent booster—compared to those who received more than two shots of the original vaccine—ranged from 30% if their last original vaccine dose was two to three months earlier, to 56% if their last original vaccine dose was more than eight months prior to the new one. The effectiveness was slightly lower for older people, ranging from 28% to 48% among those 50 years and older.

The fact that the vaccine effectiveness increased with more time since the last original vaccine dose shows that the new booster replenishes waning levels of virus-fighting antibodies, the researchers write.

The data came from the national Increasing Community Access to Testing program, which provides free COVID-19 tests at pharmacies around the country. Between Sept. 14 and Nov. 11, more than 360,000 tests for SARS-CoV-2 were performed at nearly 1,000 sites, and people were asked to report their vaccination status and previous infection history. During that time, Omicron variants BA.4/5 were dominant, but newer variants, including BQ.1 and BQ.1.1, which now account for nearly 50% of cases in the U.S., were beginning to increase. The researchers say that the data during periods when just BA.4/5 dominated were not significantly different with respect to the Omicron booster’s effectiveness when compared to periods when other variants emerged. Still, the researchers acknowledge that the results may change as newer variants take over.

Other researchers are investigating how the updated bivalent booster affects immunity—not just to the variants it targets, but also to previous and even potentially newer variants that evolve from BA.4/5. Some data suggest that vaccine-induced immunity might provide higher levels of virus-neutralizing antibodies than getting infected with the virus might, possibly because the immune system sees and reacts to vaccines in a different way than it sees and responds to pathogens like viruses. And each vaccination may also help the immune system to become more efficient at recognizing and disabling the virus.

The current real-world findings, the study authors say, point to the need to stay up to date with COVID-19 vaccines, including getting the latest Omicron booster. Bivalent boosters “provide protection against symptomatic SARS-CoV-2 infection during circulation of BA.4/BA.5 and their sublineages and restore protection observed to wane after monovalent vaccine receipt,” the study authors write.

To view the article, click HERE!
(source TIME)
FDA authorizes updated COVID-19 boosters for kids under 5
The bivalent boosters target the BA.4 and BA.5 subvariants of omicron.

The U.S. Food and Drug Administration authorized bivalent COVID-19 boosters for children between the ages of 6 months and 4 years old Thursday.

The booster, available from both Pfizer and Moderna, was previously authorized for everyone 5 years and older in October.

"More children now have the opportunity to update their protection against COVID-19 with a bivalent COVID-19 vaccine, and we encourage parents and caregivers of those eligible to consider doing so -- especially as we head into the holidays and winter months where more time will be spent indoors," FDA Commissioner Robert Califf said in a statement.

"As this virus has changed, and immunity from previous COVID-19 vaccination wanes, the more people who keep up to date on COVID-19 vaccinations, the more benefit there will be for individuals, families and public health by helping prevent severe illnesses, hospitalizations, and deaths."

The updated booster targets BA.4 and BA.5, which are subvariants of the omicron variant.

Children are eligible to receive the booster at least two months from the completion of their primary series or after receiving a separate booster dose.

The authorization means there are now more than 267 million people eligible for the booster in the U.S., according to data from the Centers for Disease Control and Prevention.

However, as of Nov. 30, only about 13% of those eligible have received an updated booster dose.

The final step before the booster can be distributed to the under age 5 category is authorization from the CDC, which must be signed off on by the agency's director, Dr. Rochelle Walensky.

When considering authorizing the updated booster, the FDA said it looked at immune response data from adults who had received the original booster, which targeted the original omicron variant BA.1, as well data from a study comparing children who received the original booster and children who only received the primary series.

"Vaccines remain the best defense against the most devastating consequences of disease caused by the currently circulating omicron variant, such as hospitalization and death," Dr. Peter Marks, director of the FDA's Center for Biologics Evaluation and Research, said in a statement. "Based on available data, the updated, bivalent vaccines are expected to provide increased protection against COVID-19."

"Parents and caregivers can be assured that the FDA has taken a great deal of care in our review, and we encourage parents of children of any age who are eligible for primary vaccination or a bivalent COVID-19 vaccine booster dose to consider seeking vaccination now as it can potentially help protect them from COVID-19 during a time when cases are increasing," the statement continued.

To view the article, click HERE.
(source ABC News)
"Tripledemic" of flu, RSV and COVID-19 strains hospitals, worries doctors as cases spike

At Mass General Hospital for Children, the pediatric ICU is at full capacity. Most patients there are on oxygen or ventilators.

"This past year has been unlike any other years in the past, with RSV season starting way, much earlier," said Dr. Laura Pugsley, nursing director of inpatient pediatrics at the hospital in Boston. 

This year has gained a troublesome distinction nationwide as a trifecta of illnesses converge to plague the health care system and its patients: Nationwide, cases of RSV, or respiratory syncytial virus, are surging along with the flu and COVID-19 infections.

Megan's 10-week-old son, Jack, has been hospitalized with RSV for nearly a week after he began having issues breathing.

"His belly was kind of sinking into his lower ribs," Megan said. "So that was the first really big scary moment. It's really scary as a parent to see that happening to your baby."

While RSV may be peaking, it is also the worst flu season in more than a decade — as COVID-19 cases are again on the rise.

"The ER is inundated with cases, and people are being hospitalized," said Dr. Douglas Chiriboga, a California family medicine doctor.

In Los Angeles County, for example, COVID-19 cases have soared 75% in the last week alone. Chiriboga said the implications of that are clear.

"I think, eventually, we are going to have that mask mandate," he said.

Doctors say all three of the now-prevalent viral infections sweeping the country could be slowed by mask-wearing. And they said now is the time to get a flu shot and a COVID-19 booster.

So far, fewer than 13% of Americans have received their updated COVID-19 boosters. That's a bad diagnosis, according to Chiriboga.

"It tells me that people are not getting the message."

To read the full article, click HERE.
(source CBS News)
CDC recommends masks again in New York City, Los Angeles and other communities as COVID cases climb

A growing number of communities are now seeing COVID-19 cases and hospitalizations at levels high enough to warrant indoor masking and other measures to curb the virus, the Centers for Disease Control and Prevention warned Thursday. A number of major cities are now mulling a return to masking measures.

According to the agency's weekly update, 13.7% of Americans now live in communities now rated at "high" COVID-19 Community Levels, up from 4.9% of the population last week. An additional 38.1% of Americans are in "medium" areas and 48.2% are in "low" areas. 

More than ten large counties with more than a million residents are now at this "high" tier: 

  • Los Angeles County, California (10,039,107 residents)
  • Maricopa County, Arizona (4,485,414)
  • Kings County, New York (2,559,903)
  • Queens County, New York (2,253,858)
  • San Bernardino County, California (2,180,085)
  • Santa Clara County, California (1,927,852)
  • New York County, New York (1,628,706)
  • Suffolk County, New York (1,476,601)
  • Bronx County, New York (1,418,207)
  • Nassau County, New York (1,356,924)
  • Pima County, Arizona (1,047,279)

The list includes much of the New York metro area. Officials in the state recently urged schools to return to indoor masking to curb the spread of COVID-19 as well as the respiratory virus RSV and influenza. Authorities in Los Angeles have also warned that indoor masking rules might return there as cases have mounted.

The updated figures come as CDC officials say they have been mulling new "pan-respiratory" benchmarks to measure the spread of all three viruses, as a possible replacement for the COVID-19 Community Levels framework. 

If incorporated into the CDC's COVID-19 recommendations, that could mean flu and RSV cases would also factor into when the agency urges Americans to don masks and take other precautions to help curb a surge that could overwhelm hospitals.

"We have also been working on trying to develop, as rapidly as possible, metrics that would be useful at state or regional levels for being able to visualize the level of overall respiratory viral activity," the CDC's Barbara Mahon said this week at a meeting of the agency's outside advisers.

Mahon said the agency hoped the metrics would be "ready to come out soon."

"Bumpy days ahead"

While Biden administration officials say they are confident this year's surge in RSV seems to have peaked in most parts of the country, and there are early signs that flu hospitalizations may have also peaked, both remain near levels as bad as some of the worst previous seasons on record.

The pace of new COVID-19 hospitalizations has also climbed nationwide, up 13.8% from the week prior. In nursing homes this week the CDC tallied the worst rate of COVID-19 infections in residents since last February.

Roughly two in three cases are now estimated to be the BQ.1 or BQ.1.1 variants. Moderna and Pfizer say their lab data suggests their updated shots will offer added protection against these Omicron strains. 

But the immune-evasive strains recently forced the FDA to bench the last available antibody treatment for COVID-19 patients.

Federal health authorities and some experts have encouraged doctors seeing vulnerable and immunocompromised patients to resort back to treatments like convalescent plasma, though they acknowledge that they can be hard to come by. Federal funding to support blood collection and boost plasma supplies earlier in the pandemic expired in 2021.

"We are seeing a clear uptick in infections of COVID pretty much in every region of the country, up about 40% over the last couple of weeks. So three challenges all arriving at the same time. There's going to be some bumpy days ahead," Dr. Ashish Jha, the White House's top COVID-19 official, told the Health Action Alliance at an event Thursday.

Jha said he urged people to seek out treatments for the disease as well as an updated COVID-19 booster.

Thanks in part to an expected slowdown in vaccinations over holiday weekends, CDC figures suggest the average pace of new COVID boosters administered has now plummeted 66% from its mid-October peak. On Wednesday, Mahon lamented the pace of shots as now "woefully slow."

Around 15.5% of adults and 34.2% of seniors now have an updated COVID booster, as of figures published Thursday. By comparison, CDC survey data estimates nearly 60% of seniors had an annual flu shot through November last year.

To read the full article, click HERE.
(source CBS News)
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Los Alamos Vaccine & Booster Information
How do I know if I'm eligible for a vaccine or booster?

Follow these links to review the CDC eligibility guidelines:




Where can I get my COVID-19 Vaccine or Omicron booster?

Visit the NMDOH Vaccine Event Calendar website for locations. The site will even identify locations to get your flu shot as well.

In addition to the clinics that use the NMDOH scheduling site, Los Alamos has other options available. Click below on the vaccine/booster resources website for more information.
Los Alamos County COVID Vaccine/Booster Resources
Visit the County COVID Page for information regarding vaccinations/boosters, click below:
COVID-19 Data Resources
CDC COVID Data Tracker - December 9, 2022

To get today's break down of positive case data, demographics information, vaccine status and more for Los Alamos County or other counties across the United States, click HERE

Johns Hopkins
COVID-19 Status Report Dashboard for Los Alamos County

NMDOH Epidemiology Reports - Daily and Weekly Data
As part of the COVID-19 pandemic response, NMDOH collects and analyzes statewide data for COVID-19 positive cases, hospitalizations, and deaths. The reports reflect these critical data and are updated weekly - click HERE
Surveys and Questions
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Los Alamos Testing Information


With the holiday season upon us, it’s important to know exactly when to test for COVID-19 in case you may have been exposed at an event or gathering. 
 
Did you also know that you can still get free, at-home COVID-19 test kits?
 
Get your COVID-19 testing frequently asked questions answered HERE.
Los Alamos County COVID Testing Resources
Visit the County COVID Page for information regarding testing, click below:
Los Alamos Treatment Information
Los Alamos County COVID Treatment Resources
Visit the County COVID Page for information regarding treatments, click below:
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